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Osteoporosis Cases

Osteoporosis Cases. Department of Geriatric Medicine Edward Warren, MD, Chair Geriatrics, Carolinas Campus, April 2012. Case 1. Osteoclasts are cells in bone that lay down new bone make vitamin D reinforce bone strength resorb bone turn into osteoblasts. Case 2.

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Osteoporosis Cases

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  1. Osteoporosis Cases Department of Geriatric Medicine Edward Warren, MD, Chair Geriatrics, Carolinas Campus, April 2012

  2. Case 1 Osteoclasts are cells in bone that • lay down new bone • make vitamin D • reinforce bone strength • resorb bone • turn into osteoblasts

  3. Case 2 A 67 year old woman who had menopause at age 45, has fractured her right wrist. She has hypothyroidism with a recent TSH of 0.1 (nl 0.5 – 5.0) and a weight of 75 kg with a height of 175 cm. Her osteoporosis risk factors include: • ectomorphic habitus • excessive thyroid hormone • post menopause • previous fracture • sedentary lifestyle

  4. Case 3 A 70 year old man is on medication and asks you about osteoporosis risk. Which medications pose risk? • acetaminophen • hydrochlorothiazide • phenytoin • prednisone • warfarin

  5. Case 4 A medication for a disease is tested against placebo. The placebo group had a 1% death rate. The treatment group had a 0.5% death rate. What is the NNT. • 50 • 100 • 200 • 250 • 500

  6. Case 5 A 67 year old woman takes phenytoin for seizures. The T-score on DXA scanning of her hip is 1.0. Should she be treated for osteoporosis prevention? • Yes • No

  7. Case 6 A 70 year old man has no risk factors from medication or illness. The T-score is - 2.6. Should he be treated for osteoporosis prevention? • Yes • No

  8. Case 7 Which intervention is most likely to prevent a hip fracture? • alendronate • calcium • conjugated estrogens • hip pads • vitamin D

  9. Answers Case 1 D Case 2 B, C, D No Hx of sedentary, BMI 25 Case 3 C, D, E Case 4 200 Case 5 Yes Case 6 No Case 7 D

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